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Biomedical subjects

H Kato

Publications and source records attributed to H Kato.

At least 667 records · Page 37Linked to original sources
PubMed1998

Urinary 7alpha-hydroxy-3-oxochol-4-en-24-oic and 3-oxochola-4,6-dien-24-oic acids in infants with cholestasis.

BACKGROUND/AIMS: Urinary 3-oxo-delta4 bile acids have been detected in infants who ultimately died of liver disease. We used qualitative and quantitative methods to compare urinary 3-oxo-delta4 bile acids in liver disease, determining their composition and evaluating the prognostic implication in patients of various ages with various liver diseases. METHODS: Gas chromatography-mass spectrometry was used to measure 3-oxo-delta4 bile acids in the urine of patients and healthy controls. RESULTS: Patients with a deficiency of 3-oxo-delta4-steroid 5beta-reductase and acute hepatic failure exhibited a significantly higher percentage of 3-oxo-delta4 bile acids in total bile acids in urine than the healthy controls or other patient groups, including those with neonatal cholestasis or biliary atresia (p<0.0001). The urinary 3-oxo-delta4 bile acids in patients with 3-oxo-delta4-steroid 5beta-reductase deficiency who had a poor prognosis were mainly 7alpha-hydroxy-3-oxochol-4-en-24-oic acid and 3-oxochola-4,6-dien-24-oic acid. CONCLUSIONS: Our results indicate that an increase in the 7alpha-hydroxy-3-oxochol-4-en-24-oic acid and 3-oxochola-4,6-dien-24-oic acid in the urine of patients with hepatobiliary disease indicates a poor prognosis.

Adolescent↗
PubMed1998

Noninvasive evaluation of myocardial ischemia in Kawasaki disease: comparison between dipyridamole stress thallium imaging and exercise stress testing.

The sensitivities of dipyridamole stress thallium 201 single photon emission computed tomography (SPECT) and treadmill exercise testing in the detection of myocardial ischemia were compared. Thirty-eight patients with Kawasaki disease and 11 age-matched controls participated in the study. Fifteen of the 38 patients with Kawasaki disease had marked coronary artery stenosis (> 75%) in at least one vessel. SPECT scans were obtained immediately after dipyridamole infusion and 4 hours later. The sensitivity of SPECT for detection of coronary stenosis was 80% (12/15), whereas that of treadmill exercise testing was only 33% (5/15) (p < 0.001). Although the sensitivity of SPECT significantly exceeded that of treadmill exercise testing among patients with coronary stenosis in only one vessel (p < 0.05), such benefits were not found for patients with stenosis in two or three vessels. These findings suggest that dipyridamole stress SPECT has a higher degree of sensitivity in the detection of myocardial ischemia than does treadmill exercise testing, especially for patients with single-vessel disease.

Child↗
PubMed1998

Surgery for thoracic esophageal carcinoma with clinically positive cervical nodes.

OBJECTIVE: We attempted to determine whether and under what circumstances surgical intervention should be recommended for patients with clinically positive cervical nodes for metastasis from thoracic esophageal carcinoma by pretreatment examination. METHODS: The survival of the patients was compared using factors including anatomic subsites of the tumor, T categories, subdivisions of N categories, and R classification according to the TNM classification. RESULTS: The 5-year survival of 63 patients who underwent surgery for primary therapy was 26.7%. There was no statistically significant difference between the postoperative survivals when compared according to the location of the tumors. As a matter of course, the patients with later stages of the disease had worse survival. However, by the multivariable analysis, significant difference was recognized between the patients with tumor invading adjacent structures (T4) and those without and between the patients who received curative resection and those who did not. The 5-year survival of 47 patients who underwent surgery without residual tumor was 32.9%. CONCLUSION: Even when the patient had clinically positive cervical nodes from thoracic esophageal carcinoma, they had a possibility of long-term survival after curative resection with neck lymph node dissection. An operation is thus indicated for curative intent. Accurate pretreatment evaluation is important when deciding which patients require surgery and how to carry out a curative surgical procedure without residual tumor.

Adenocarcinoma↗
PubMed1998

Malignancy associated changes in bronchial epithelial cells and clinical application as a biomarker.

A total of 74 bronchial brushing specimens, 24 from patients with advanced stage cancer, eight from patients with CIS, 31 from patients with atypical metaplasia and 11 from normal subjects were examined for the existence of malignancy associated changes (MAC). Conventional fiberoptic bronchoscopy and fluorescence endoscopy was carried out on every case. Each case was classified according to the highest grade of abnormality diagnosed by bronchial biopsy of the suspect areas. During the endoscopy examination, a bronchial brushing specimen was obtained from a visually normal area very remote from the abnormal area as possible such as the opposite lung or another lobe. The bronchial brushing specimens were fixed, mounted and stained by a DNA specific method and approximately 1500 images of individual nuclei per case were captured by an automated high resolution image cytometry. For each of these images, more than 100 nuclear features such as size, shape and chromatin spatial organization were calculated. Discriminant function analysis revealed nuclear features which differentiated between normal bronchial cell nuclei from the normal subjects and ostensively normal nuclei (MAC cell nuclei) from the lung cancer patients. The best discrimination was achieved when the frequency of individual cells expressing MAC was 50% or greater. With this threshold, 75% of the patients with invasive cancer and CIS were correctly classified. Fifty percent of those with severe or moderate atypia and 35% with mild atypia were also MAC positive. The frequency of cells expressing MAC also increased as the degree of abnormality of the groups increased. MAC may be a useful criterium to determine biological behavior of the intra-epithelial (pre-invasive) neoplasia.

Aged↗
PubMed1998

Immunohistochemical, ultrastructural and molecular study of well differentiated adenocarcinomas of the lung predominantly composed of goblet cells.

In order to clarify the morphological and biological characteristics of well differentiated adenocarcinoma of the lung predominantly composed of goblet cells (WDAG), histopathological examinations, including some molecular biological procedures, were carried out using 42 surgical specimens of primary lung carcinoma which were predominantly (>50% of the total cell population) or totally composed of goblet cells. The subjects included 19 men and 21 women, ranging in age from 41 to 81 (mean 60 years old) with predominantly nodular, peripherally located lesions. Ultrastructural examination revealed characteristic apical microvillous filamentous core rootless (AFCR) in some, but not all, cases. Histologically, these AFCR corresponded well with structures stained by phosphotungstic acid hematoxylin (PTAH). The goblet cells of WDAG were divided into PTAH-positive (26 cases) and -negative (16 cases) groups. The PTAH-positive group had larger tumor size, greater number of intrapulmonary and extrapulmonary metastases and shorter disease-free interval. The immunoexpression of p53 protein (60%) and rate of K-ras point mutation (84%) were also higher in the PTAH-positive group. Therefore the goblet cell population of WDAG, though it may appear morphologically homogeneous under light microscopy, is actually composed of heterogeneous groups of cells with different histopathological characteristics and biological behavior.

Adenocarcinoma↗
PubMed1998

Influence of E-cadherin dysfunction upon local invasion and metastasis in non-small cell lung cancer.

E-Cadherin (ECD), a transmembrane cell adhesion molecule, is associated with three kinds of cytoplasmic proteins (alpha-catenin, beta-catenin and plakoglobin), and formation of the cadherin-catenins adhesion complex is indispensable for tight cell-to-cell adhesion in adherence junctions. There is a high possibility that dysfunction of ECD reflects increased potential for local invasion and distant metastasis. We investigated the relationship between the expression of cadherin-catenin adhesion complex and the clinicopathological features in 81 cases of non-small cell lung cancer. There were statistically significant relationships between the expression of ECD and lymph node metastasis (P = 0.016) and between the expression of ECD and pathological stage (P = 0.006). Reduction of alpha-catenin expression was associated with local invasion and pathological stage. Dividing the 81 cases into two groups based on ECD function revealed a statistically significant relationship between ECD function and all clinicopathological factors investigated (local tumor invasion P = 0.033, lymph node metastasis P<0.001, pathological stage P<0.001). Evaluation of ECD function using the expression of cadherin-catenin adhesion complex is useful to evaluate tumor malignancy of non-small cell lung cancer.

Adenocarcinoma↗
PubMed1998

Peripheral non-small cell lung cancers 2.0 cm or less in diameter: proposed criteria for limited pulmonary resection based upon clinicopathological presentation.

Clinical features of peripheral non-small cell lung cancer 2.0 cm or less were retrospectively analyzed. Nodal status and prognosis in relation to tumor diameter and histologic type were investigated in 171 consecutive patients with peripheral clinical T1N0M0 non-small cell lung carcinomas 2 cm or less in diameter and who had undergone surgical resection between 1976 and 1997. Of the 171 patients, 136 had adenocarcinoma, 27 had squamous cell carcinoma, four had large cell carcinoma, three had carcinoid and one had adeno-squamous carcinoma. There was no statistically significant difference in the incidence of stage I cases between adenocarcinoma and squamous cell carcinoma. Lymph node involvement was recognized in 30 (17.5%) patients: ten (5.8%) at N1 nodes and 20 (11.7%) at N2 nodes. Lymph node metastasis was significantly more common in tumors 1.5-2.0 cm in diameter (22%) than in those 1.5 cm or less in diameter (14.0%, P = 0.0490). There was no lymph node metastasis in tumors 1.0 cm or less in diameter. The 5-year survival rates cases with or without lymph node involvement were 63.3 and 75.3%, respectively, showing significant difference (P = 0.0338). The result of the present study suggested that systematic mediastinal and hilar lymph node dissection is necessary even for cases with tumor diameter less than 2 cm. However, if the tumor is within 1.0 cm in diameter, mediastinal lymph node dissection might be dispensable; therefore, these cases are good candidates for video-assisted lobectomy.

Adult↗
PubMed1998

Surgical treatment of congenital metacarpal synostosis of the ring and little fingers.

Fifteen hands with congenital metacarpal fusions were treated operatively by osteotomy combined either with the use of a silicone block or a distraction device. The aim of the silicone block was to separate the fused metacarpals, but it was buried in the metacarpals at follow-up, with recurrence of fusion. By the distraction technique, 13 mm of lengthening was obtained. The average length of the little metacarpal was 88% of that of the long finger metacarpal. Both methods were effective in correcting the abduction deformity of the little finger by a mean of 34 degrees, and increasing the range of motion of the metacarpophalangeal joint to 28 degrees of active flexion. Although the distraction method took longer than the silicone block method, the final appearance of the hand was better.

Child↗
PubMed1998

Clinical features and management of traumatic posterior interosseous nerve palsy.

The clinical features and results of treatment were reviewed in 17 traumatic palsies of the posterior interosseous nerve. Variations in clinical features depended on whether the recurrent branch or descending branch of the posterior interosseous nerve was injured. Seven patients had nerve repair, and two were treated by tendon transfers. Eight patients were treated conservatively. Sixteen of 17 patients recovered to more than M4 motor power at final follow-up. Associated muscle damage worsened the functional result.

Adolescent↗
PubMed1998

Proximal row carpectomy versus limited wrist arthrodesis for advanced Kienböck's disease.

The outcomes in 20 patients with advanced Kienböck's disease treated by proximal row carpectomy (seven patients) or limited wrist arthrodesis (13 patients) were reviewed retrospectively. Postoperatively, the results were more satisfactory in terms of wrist pain, the range of wrist flexion-extension, and grip strength following limited wrist arthrodesis than after proximal row carpectomy, although the differences were not statistically significant. We recommend scaphotrapeziotrapezoid arthrodesis in selected patients with advanced Kienböck's disease who have a fragmented lunate.

Adolescent↗
PubMed1998

Ulnar styloid malunion with dislocation of the distal radioulnar joint.

Four patients with dorsal dislocation of the distal radioulnar joint and ulnar styloid malunion had corrective osteotomy of the ulnar styloid. Dislocation of the distal radioulnar joint was reduced in three of four patients. Subluxation persisted in the remaining patient. Wrist function improved in all patients. These results support the contention that a displaced ulnar styloid fracture with distal radioulnar joint dislocation should be reduced and internally fixed. Corrective osteotomy is recommended for malunion of the ulnar styloid associated with dislocation of the distal radioulnar joint.

Adolescent↗
PubMed1998

Localization of nerve growth factor, trkA and P75 immunoreactivity in the hippocampal formation and basal forebrain of adult rats.

In the immunohistochemical staining of nerve growth factor, it has been reported that fixation-dependent lability of nerve growth factor hampers its localization. In the present study, we used two different polyclonal antibodies to immunostain nerve growth factor in rat brain tissue. We found that in paraformaldehyde-fixed (immersion- or perfusion-fixed) brains, nerve growth factor-like immunoreactivity was located primarily in the cytoplasmic membrane and fiber tract of hippocampal neurons and was sparse in cortical neurons. When fresh frozen brain sections were fixed in paraformaldehyde solution, nerve-growth factor-like immunoreactivity was distributed evenly in the cell body. However, when fresh frozen brain sections were fixed in acetone, immunoreactivity to nerve growth factor was present as discrete or confluent dense particles in the cell body, especially in the nuclear region. Also, when paraformaldehyde-perfusion-fixed brain sections were heat treated in salt solution before immunostaining, nerve growth factor-like immunoreactivity could be retrieved in the cytoplasmic and nuclear regions. The hippocampal formation, cerebral cortex and basal forebrain expressed nerve growth factor-like immunoreactivity. Double immunostaining in fresh frozen brains showed that the low-affinity nerve growth factor receptor (p75) co-expressed with nerve growth factor and trkA proto-oncogene in basal forebrain neurons. Our study shows that formaldehyde fixation can mask nerve growth factor antigen, and special treatment, such as heating, is needed to retrieve nerve growth factor antigen to permit immunohistochemical detection. For immunohistochemical study of nerve growth factor in rat brain tissue, successful immunostaining can be obtained by using fresh frozen brains to prevent the masking effect of fixatives or by using paraformaldehyde-fixed brains with heat treatment. It is likely that nerve growth factor is synthesized and accumulated mainly in the cell body but not in the fiber tracts, which is similar to the distribution of its messenger RNA. The co-existence of p75 with nerve growth factor and trkA in basal forebrain neurons suggests the role of low- and high-affinity receptors in regulating the trophic effect of nerve growth factor.

Animals↗
PubMed1998

Functional results of low median and ulnar nerve repair with intraneural fascicular dissection and electrical fascicular orientation.

Twenty-eight low median nerve injuries and 23 low ulnar nerve injuries were repaired using intraneural fascicular dissection and electrical fascicular orientation. Eleven freshly lacerated nerves were seen within 48 hours after injury; 40 nerve lacerations were chronic. Fascicular orientation between sensory and motor fascicles at the proximal nerve end could be accurately differentiated in 47 nerves (92%) independent of whether it was acute or chronic. At the distal nerve end in fresh lacerations, the motor fascicles could be determined conclusively by muscle contraction with sequential electrical stimulation of the fascicles. In chronic nerve lacerations, the distal fascicles could be estimated anatomically after internal neurolysis. After fascicular orientation, nerves were repaired with end-to-end group fascicular suture or interfascicular sural nerve grafting. Twenty-four nerves repaired with end-to-end suture and 13 nerves repaired with nerve grafting were monitored more than 25 months. Satisfactory sensory results (i.e., S3+ or S4 functions) were obtained in 29 nerves (78%) and M4 or M5 motor functions were achieved in 29 nerves (78%). There were no patients who needed additional tendon transfers to reconstruct thumb opposition or to correct claw finger deformity. These results suggest that low median or ulnar nerve lacerations, whether acute or chronic, partial or complete, may be successfully repaired with the aid of electrical fascicular orientation with or without intraneural fascicular dissection.

Adolescent↗
PubMed1998

Ulnar shortening for triangular fibrocartilage complex tears associated with ulnar positive variance.

Twenty-five patients with triangular fibrocartilage complex (TFCC) tears associated with ulnar positive variance who did not respond to conservative management were treated by ulnar shortening. The follow-up period averaged 35 months. All patients complained of pain, restricted forearm rotation, and weakness of grip. Arthroscopy was performed in 23 of 25 wrists to assess the status of the TFCC and the degree of the degenerative change of the proximal aspect of the lunate and triquetrum. Arthroscopic findings consisted of 15 class 1 and 8 class 2 tears according to Palmer's classification. When the TFCC showed a traumatic flap tear, only the torn flap was removed arthroscopically. Ulnar shortening averaged 3 mm. Transverse osteotomies healed in all patients at a mean postoperative time of 7 weeks. Twenty-three patients had either complete relief or occasional mild pain of the wrist. Two patients with persistent pain had additional procedures performed. Postoperative x-ray films revealed slight degenerative changes at the distal radioulnar joint in 7 patients. Complications included 1 reflex sympathetic dystrophy and 2 fractures through the osteotomy site after early plate removal. Ulnar shortening is a useful procedure for TFCC tears associated with ulnar positive variance.

Adolescent↗